National Home Care
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As more elders are choosing to age in place, there is an increasing need for in-home assistance. There are a variety of home-care options available, including both medical and non-medical care.
Medical care is usually provided by a skilled nurse from a Medicare-certified agency. Skilled home-care is a Medicare Part B benefit and the person receiving the care is required to be home-bound. The care is usually short-term, following an inpatient hospitalization. Examples of the type of conditions requiring skilled nursing might be post-surgery wound care, monitoring vital signs for an unstable medical condition or pain medication management. In addition, physical therapy following a hip or knee replacement is usually a covered benefit. A physician's order is required for care to be covered by Medicare.
Non-medical care includes personal care, homemaking and companion services. Personal care can be assistance with the activities of daily living (ADLs), such as eating, bathing, dressing, toileting, and transferring. Hands-on care is provided by home care or personal care aides who may be certified or licensed by the state. Companions or homemakers can assist with light housekeeping, grocery shopping, laundry, meal preparation, medication prompting, transportation and socialization. They do not provide hands-on care and are not usually certified or licensed. Both personal care and homemaking/companionship are considered non-skilled assistance.
The national average cost for non-skilled care hired through an agency is $18 per hour, with a range of $15 to $25 per hour depending on the geographical location. The average cost of independently hiring a caregiver can lower costs by 10 to 30 percent.
Benefits and Drawbacks
There are benefits and drawbacks to both going through an agency and hiring independently. If you choose to go through a home care agency, they do the background checks for you, their workers are usually licensed and bonded, they handle tax and liability insurance and they provide supervision and back up coverage. Agencies usually cost more, have a minimum number of hours required per shift and you may have multiple caregivers.
Hiring privately gives you more control over who you hire, may be less expensive and may be able to provide more flexibility. However, hiring independently means that you are responsible for taxes, Social Security withholding, supervision, back up care and liability issues.
Ultimately the choice is up to you about what fits your and your loved one's needs -- and bank account.
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